scholarly journals Delineation of factors associated with prolonged length of stay after laparoscopic ventral hernia repair leads to a clinical pathway and improves quality of care

2015 ◽  
Vol 30 (4) ◽  
pp. 1614-1618 ◽  
Author(s):  
Jennifer Leonard ◽  
Tina J. Hieken ◽  
Malek Hussein ◽  
W. Scott Harmsen ◽  
Mark Sawyer ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Length Of Stay ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Clinical Pathway ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
Prolonged Length ◽  
Factors Associated

Recurrence and Pseudorecurrence after Laparoscopic Ventral Hernia Repair: Predictors and Patient-focused Outcomes

2014 ◽  
Vol 80 (2) ◽  
pp. 138-148 ◽  
Author(s):  
Stacey A. Carter ◽  
Stephanie C. Hicks ◽  
Reshma Brahmbhatt ◽  
Mike K. Liang
Keyword(s):  
Surgical Technique ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Multivariate Analyses ◽  
Surgical Site Infections ◽  
Hernia Recurrence ◽  
Laparoscopic Ventral Hernia Repair ◽  
Factors Associated ◽  
Hernia Size

Laparoscopic ventral hernia repair (LVHR) is gaining popularity as an option to repair abdominal wall hernias. Bulging after repair remains common after this technique. This study evaluates the incidence and factors associated with bulging after LVHR. Between 2000 and 2010, 201 patients underwent LVHR at two affiliated institutions. Patients who developed recurrence or pseudorecurrence (seroma or eventration) were analyzed with univariate and multivariate analyses to identify predictors of these complications. Of the 201 patients who underwent LVHR, 40 (19.9%) patients developed a seroma, 63 (31.3%) patients had radiographically proven eventration, and 25 (12.4%) patients had a hernia recurrence. On multivariate analysis, seromas were associated with number of prior ventral hernia repairs, surgical site infections, and prostate disease. Mesh eventration was associated with hernia size and surgical technique. Tissue eventration was associated with primary hernias and surgical technique. Hernia recurrence was associated with incisional hernias and mesh type used. Recurrence and pseudorecurrence are important complications after LVHR. Large hernia size, infections, and surgical technique are important clinical factors that affect outcomes after LVHR.

Effect of Laparoscopic Ventral Hernia Repair on Quality of Life (QOL) Outcomes in Primary and Recurrent Hernias

2018 ◽  
Vol 227 (4) ◽  
pp. e133
Author(s):  
Javier Otero ◽  
Kathryn A. Schlosser ◽  
Angela M. Kao ◽  
Michael R. Arnold ◽  
Tanushree Prasad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair

scholarly journals P089 THE IMPACT OF VENTRAL HERNIA REPAIR ON PATIENT-REPORTED QUALITY OF LIFE: IDENTIFYING FACTORS ASSOCIATED WITH IMPROVEMENT

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Martin Morris ◽  
Viren Patel ◽  
Adrienne Christopher ◽  
Robyn Broach ◽  
John Fischer
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Abdominal Hernia ◽  
Factors Associated ◽  
Patient Reported ◽  
The Impact

Abstract Aim Assessing pre- and postoperative quality of life (QoL) is essential to quantify the magnitude of improvement in disease burden after ventral hernia repair (VHR). Here, we identify patient and operative factors associated with QoL improvement after VHR. Material and Methods Patients that underwent VHR by a single surgeon were retrospectively identified and included if they had minimum 1 year of follow-up, and completed pre- and postoperative Abdominal Hernia-Q (AHQ) questionnaires. Patients were divided into quintiles based on absolute pre- to postoperative improvement in AHQ score. Chi-squared and fisher’s exact tests were used for categorical data, and Student’s t-test for continuous data, as appropriate. Results Compared to the lowest quintile (n = 27, follow-up 32.6 months, mean improvement 3.24 [SD 10.4]), patients in the highest quintile (n = 26, follow up 23.9 months, mean improvement 66.3 [SD 12.1]) were female (76.9% vs 37.0%, p = 0.005) with a greater number of previous hernia repairs (mean 2.12 vs. 0.78, p < 0.005) and previous abdominal surgeries (mean 4.0 vs 2.0, p < 0.001). Patients with greater improvement also had higher incidences of delayed healing (42.3% vs 7.41%), required more office visits (5.54 vs 3.89), and had higher inpatient costs ($30,084 USD vs. $16,886, all p < 0.05). No significant differences were seen in terms of race, ethnicity, body mass index, age, length of stay, Clavien-Dindo scores, hernia recurrence, or other postoperative complications. Conclusions Despite increased preoperative risk and healthcare burden, some of the most significant QoL improvement after VHR is demonstrated in patients with complex repairs and recoveries. This indicates the global utility of VHR regardless of patient demographics and complicating perioperative factors.

scholarly journals Postoperative Comparison In Open Vs. Laparoscopic Ventral Hernia Repair In Obese Patients

2017 ◽  
Vol 23 (1) ◽  
pp. 13-16
Author(s):  
Iuliana Dogaru ◽  
M. Avram ◽  
M. Gherghinoiu ◽  
V. Morosan ◽  
N. Ciufu ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Laparoscopic Approach ◽  
Operation Time ◽  
Laparoscopic Ventral Hernia Repair ◽  
Open Approach ◽  
Obese Patients ◽  
Hospitalization Costs

Abstract Introduction: Obesity is an important problem in our society. Recent studies shows that laparoscopic ventral hernia repair has advantages in obese patients comparing with the standard open approach. This study wants to compare length of stay (LOS), hospitalization costs (HC) and operative time (OT) in laparoscopic and open ventral hernia repair. Methods: A retrospective study of obese patients (BMI>30kg/m2) that underwent ventral hernia repair between 2014 and 2015 were included. We compared demographics, hernia size, OT, LOS, HC between the two approaches. Results: 100 patients with ventral hernia repair were included, 11 had laparoscopic approach (11%). Laparoscopy was performed only in elective surgery and for small defects. The operation time was almost the same (119.09 vs.118.87 min). The length of stay was significantly longer in open approach (8.53 vs. 2.9 days) and hospitalization costs were higher for laparoscopic repair. Conclusions: Laparoscopy offers a better length of stay, but the costs remains higher for this approach.

scholarly journals Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial

BMJ ◽  
2020 ◽  
pp. m2457 ◽  
Author(s):  
Oscar A Olavarria ◽  
Karla Bernardi ◽  
Shinil K Shah ◽  
Todd D Wilson ◽  
Shuyan Wei ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Ventral Hernia Repair ◽  
Controlled Trial ◽  
Emergency Department Visits ◽  
Laparoscopic Ventral Hernia Repair ◽  
Wound Complications ◽  
Robotic Ventral Hernia Repair

AbstractObjectiveTo determine whether robotic ventral hernia repair is associated with fewer days in the hospital 90 days after surgery compared with laparoscopic repair.DesignPragmatic, blinded randomized controlled trial.SettingMultidisciplinary hernia clinics in Houston, USA.Participants124 patients, deemed appropriate candidates for elective minimally invasive ventral hernia repair, consecutively presenting from April 2018 to February 2019.InterventionsRobotic ventral hernia repair (n=65) versus laparoscopic ventral hernia repair (n=59).Main outcome measuresThe primary outcome was number of days in hospital within 90 days after surgery. Secondary outcomes included emergency department visits, operating room time, wound complications, hernia recurrence, reoperation, abdominal wall quality of life, and costs from the healthcare system perspective. Outcomes were pre-specified before data collection began and analyzed as intention to treat.ResultsPatients from both groups were similar at baseline. Ninety day follow-up was completed in 123 (99%) patients. No evidence was seen of a difference in days in hospital between the two groups (median 0 v 0 days; relative rate 0.90, 95% confidence interval 0.37 to 2.19; P=0.82). For secondary outcomes, no differences were noted in emergency department visits, wound complications, hernia recurrence, or reoperation. However, robotic repair had longer operative duration (141 v 77 min; mean difference 62.89, 45.75 to 80.01; P≤0.001) and increased healthcare costs ($15 865 (£12 746; €14 125) v $12 955; cost ratio 1.21, 1.07 to 1.38; adjusted absolute cost difference $2767, $910 to $4626; P=0.004). Among patients with robotic ventral hernia repair, two had an enterotomy compared none with laparoscopic repair. The median one month postoperative improvement in abdominal wall quality of life was 3 with robotic ventral hernia repair compared with 15 following laparoscopic repair.ConclusionThis study found no evidence of a difference in 90 day postoperative hospital days between robotic and laparoscopic ventral hernia repair. However, robotic repair increased operative duration and healthcare costs.Trial registrationClinicaltrials.gov NCT03490266.

Pain, quality of life and recovery after laparoscopic ventral hernia repair

Hernia ◽  
2008 ◽  
Vol 13 (1) ◽  
pp. 13-21 ◽  
Author(s):  
J. R. Eriksen ◽  
P. Poornoroozy ◽  
L. N. Jørgensen ◽  
B. Jacobsen ◽  
H. U. Friis-Andersen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair

Primary Fascial Closure During Laparoscopic Ventral Hernia Repair Improves Patient Quality of Life

2020 ◽  
Vol 271 (3) ◽  
pp. 434-439 ◽  
Author(s):  
Karla Bernardi ◽  
Oscar A. Olavarria ◽  
Julie L. Holihan ◽  
Lillian S. Kao ◽  
Tien C. Ko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
Fascial Closure ◽  
Primary Fascial Closure

scholarly journals Long term outcome and elasticity of a polyester mesh used for laparoscopic ventral hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
P. J. O’Dwyer ◽  
C. Chew ◽  
H. Qandeel
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
Ct Scans ◽  
Unique Problem ◽  
Polyester Mesh

Abstract Background Repair of a ventral hernia is increasingly being performed by a laparoscopic approach despite lack of good long term follow up data on outcomes. The aim of this study was to examine the long term performance of a polyester mesh and to assess its elastic properties in patients undergoing laparoscopic ventral hernia repair. Methods All patients being assessed for a ventral hernia repair between August 2011 and November 2013 were placed on a prospective database. Those undergoing laparoscopic repair with a polyester mesh were seen at clinic at one month and one year, while their electronic records were assessed at 34 months (range 24–48 months) and 104 months (range 92–116 months). In addition, CT scans of the abdomen and pelvis performed for any reason on these patients during the follow up period were reviewed by a consultant gastrointestinal radiologist. Mechanical failure testing of the mesh was also performed. Results Thirty-two of the 100 patients assessed for ventral hernia repair had a laparoscopic repair with a polyester mesh. Nineteen (59%) had CT scans performed during the follow-up period. No recurrence was recorded at 34 months, while three (9.4%) had a recurrence at 104 months. Two had central breakdown of the mesh at 81 and 90 months, while 1 presented acutely at 116 months after operation. Mesh had stretched across the defect by an average of 21% (range 5.7–40%) in nine patients. Mechanical testing showed that this mesh lost its elasticity at low forces ranging between 1.8 and 3.2 N/cm. Conclusion This study shows that late recurrence is a problem following laparoscopic ventral hernia repair with polyester mesh. The mesh loses it elasticity at a low force. This combined with degradation of mesh seems the most likely cause of failure. This is unlikely to be a unique problem of polyester mesh and further long-term studies are required to better assess this operative approach to ventral hernia repair.

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